Nosocomial bloodstream infections caused by Klebsiella pneumoniae: impact of extended-spectrum beta-lactamase (ESBL) production on clinical outcome in a hospital with high ESBL prevalence

Nosocomial bloodstream infections caused by Klebsiella pneumoniae: impact of extended-spectrum beta-lactamase (ESBL) production on clinical outcome in a hospital with high ESBL prevalence

Autor Marra, Alexandre Rodrigues Autor UNIFESP Google Scholar
Wey, Sergio Barsanti Autor UNIFESP Google Scholar
Castelo Filho, Adauto Autor UNIFESP Google Scholar
Gales, Ana Cristina Autor UNIFESP Google Scholar
Cal, Ruy Guilherme R Google Scholar
Carmo Filho, Jose Roberto do Autor UNIFESP Google Scholar
Edmond, Michael B. Google Scholar
Pereira, Carlos Alberto Pires Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Hosp Israelita Albert Einstein
Virginia Commonwealth Univ
Resumo Background: the frequency of ESBL producing Klebsiella pneumoniae bloodstream infections ( BSI) is high in Brazilian hospitals, however little is known regarding what role, if any, resistance plays in the expected outcome in hospitals with a high prevalence of these pathogens.Methods: From 1996 to 2001, hospital acquired K. pneumoniae BSI were evaluated retrospectively. Each patient was included only once at the time of BSI. ESBL producing strains were identified using the E-test method. the association of variables with the mortality related to bacteremia was included in a stepwise logistic regression model.Results: One hundred and eight hospital acquired K. pneumoniae BSI met criteria for inclusion. Fifty two percent were due to ESBL producing strains. the overall in-hospital mortality was 40.8%. Variables independently predicting death by multivariate analysis were the following: mechanical ventilation ( p = 0.001), number of comorbidities ( p = 0.003), antimicrobials prescribed before bacteremia ( p = 0.01) and fatal underlying disease ( p = 0.025).Conclusion: Bacteremia due to ESBL producing K. pneumoniae strains was not an independent predictor for death in patients with BSI. An increased mortality in hospital-acquired BSI by K. pneumoniae was related to the requirement for mechanical ventilation, more than two comorbidities, the previous use of two or more antibiotics, and the presence of a rapidly fatal disease.
Idioma Inglês
Data de publicação 2006-02-14
Publicado em Bmc Infectious Diseases. London: Biomed Central Ltd, v. 6, 8 p., 2006.
ISSN 1471-2334 (Sherpa/Romeo, fator de impacto)
Publicador Biomed Central Ltd
Extensão 8
Fonte http://dx.doi.org/10.1186/1471-2334-6-24
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000235548000001
Endereço permanente http://repositorio.unifesp.br/handle/11600/28746

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